by Peter Quenter

It is generally more the female clients who persist with follow-up visits over a prolonged period of time.

...women more ..frequently express the desire for a more holistic approach...

I will not hesitate, now and occasionally, and in unobtrusive moments... to mention briefly a few of my own experiences in life...

The nature of the practice of homeopathy provides, I believe, a conducive environment to develop worthwhile human relationships...

I ask his name, he seems disturbed by my taking a sheet of paper to make notes on.

He begins to show quite obvious signs of annoyance at my (stupid?) questions...

He doesn't quite express any interest in what I am saying...

On entering the consultation room with me, she begins to explain her symptoms even before reaching her chair.

The practitioner may exhibit symptoms of his own, be they ever so subtle or subconscious, that may interfere with the process of case taking and management.

"The Doctor of the future will not give medicines, but will be someone who is able to listen." 
— Thomas A. Edison

How can a male prescriber can alter his communication efforts when dealing with a female patient versus dealing with a male patient? This was the subject proposed to me. After reviewing and recalling the general character of consultations in my office, it seems to me that the issue is not so much one of gender, but rather of how we communicate in general, and in homeopathic practice specifically, that determines the efficiency of our homeopathic consultations.

Are there essential gender-based differences in how we can best relate to our clients?

Certainly, there are some differences between female and male clients in general, but any of the specific characteristics can be found in either sex, depending on the individual personality. From my own experience:

By fortunate nature, it seems women are emotionally much more open and in touch with their feelings. This often makes it easier for a homeopath to delve into the core of the case of a female client. By unfortunate nature of our society, women's stories, as revealed in the homeopathic office, often have strong traumatic emotional components. Women may intuitively sense that health and illness develop from within and from an imbalance between body, emotions, and mind. Thus, women more frequently express the desire for a more holistic approach, which for them explicitly includes a relationship of emotional trust and a sense of caring beyond simply treating the physical symptoms.

We may think that men are in general not used to revealing emotional issues. However, I find that this is not as prevalent as it seems. It is more a question of how we as practitioners feel about talking about emotions. If we are open and natural about it, it is much more likely that the male client will have an easier time with opening up, too.

Of course, these are generalizations with which I do not feel very comfortable. With any of the aspects that we commonly attribute to either male or female, it is just a matter of time until you will find a man in your office who displays exactly what we attributed to women, and vice versa. Similarly, you will find women consulting you, who have all the male characteristics. Certainly, some men manifest more male energy than others, and some women manifest more female energy than others. Some men express more female qualities than others, and some women express more male qualities then others.

I have experienced one specific difference between male and female clients: There have been occasions when female clients have expressed that after several visits of telling me much detail about their life (which is quite usual in the process of homeopathic treatment) they don't know anything about me. A feeling of balance seems to be missing. I have not yet heard this from a male client.

Establishing trust without authority

Even though I was taught "The client is not interested in your life," and "Don't talk about yourself," I will not hesitate, now and occasionally, and in unobtrusive moments (usually when the conversation tends toward this direction), to mention briefly a few of my own experiences in life, situations I have encountered that relate to the client's situation in some way, or simply facts about my lifestyle, my beliefs. If related in a rather factual manner, without excessive emotional expression, it is received likewise. Certainly one would not want the homeopath to start telling about their emotional traumas and possibly even have a breakdown in the office, but little neutral pieces of information do give the client a sense of personal touch and trusting acquaintance.

Professionalism and professional image are important, yes. But holistic health means we are dealing with human nature! The old country doctor certainly knew his clients' private lives because he visited them in their homes, maybe even would have been offered lunch with one or the other. And the people knew the doctor as one of their community. Today, finding the appropriate symmetry between inter-human communication and social and professional 'image' can become a delicate balancing act. The nature of the practice of homeopathy provides, I believe, a conducive environment to develop worthwhile human relationships, while at the same time offering a basis for growth and learning for both the client and the practitioner. A client's respect for the homeopath, and a homeopath's respect for the client are, as I see it, more important, more beneficial and more conducive to the practitioner-client relationship than the homeopath holding a position of authority over the client.

Communication requires a self-aware practitioner

Communication between practitioner and client is dependent on many factors. Here are two examples of the opposite extremes, which one may encounter in practice as I did (C = client, P = practitioner):

A young man, about thirty years of age, came into the office without an appointment (we do not have a walk in clinic). He seemed to have been looking around in the waiting room for a few minutes before I went to see who was there. He said he just wanted someone to look at his leg, he had a rash.

C: ...Do you have time?!

P: (A quick glance to my watch.) Yes, I do have a few minutes, come in.

In the consultation room he sits down. I introduce myself and wait a second or two to give him a chance to tell me his name. He doesn't, just sits there and looks to the side, almost like he is here against his will. I ask his name, he seems disturbed by my taking a sheet of paper to make notes on.

P: You are aware that I am not a medical doctor?! This is a natural health clinic, we use only natural means for treatment, like herbs, nutrition, and homeopathy. We do not use any medical or pharmaceutical drugs.

The sign outside our office door indicates a natural health/homeopathy office, and in our waiting room we have a sign up indicating that for a diagnosis of any condition to, please, consult a medical practitioner.

He shrugs his shoulders, so I started with the obvious questions like "Where is the rash, what is it like?" He shows me his lower leg.

P: Is it itching ?

C: Yeah...I guess....don't you have something to put on it....? !!

He sits sideways to me, and does not look at me.

P: Is it painful?

C: Ehhh?

P: Like burning, or something?

C: I don't know. Can you tell me what it is?!

P: Well, when did it start?

C: I don't know...a week ago or so... or no...three, maybe?

P: Were you out in the woods or get in contact with any plants, or got bitten?

C: No, I don't know. I was in the garden, this weekend.

He begins to show quite obvious signs of annoyance at my (stupid?) questions, even though he seems to make internal efforts to keep his calm.

P: I am not a medical doctor, so I cannot make a diagnosis. Did you have a medical doctor have a look at it yet?

C: No, that's why I am here now.

P: We practice natural health here, herbs, nutrition, homeopathy.

I ask casually and in, what I would consider, an encouraging tone of voice:

P: Do you know about natural health? Did you ever see a natural health practitioner before?

Long silence...hesitation...he looks away.

C: Ehh...... Y..ye..yes!........... I only want something to put on it! Don't you have anything!!?

P: Well, I don't have anything like you would get from a doctor!

I start an attempt to explain that in natural health and homeopathy we rather not put anything on externally, and so forth. He doesn't quite express any interest in what I am saying, he sits there, facing sideways away from me, and seems to wish just to ignore me.

P: Maybe it would be better to have a medical doctor see your leg to be sure what it is! There are several here in this building on the same floor, as you probably noticed when you came here.

C: So you don't have a cream...or something...!? That means the time here now was wasted.!!?

This is the first time since entering the office that he speaks a full sentence and in normal loudness, and even looks at me while saying something. So I say that I am sorry not to have anything for him to put on his rash. I encourage him again to see a medical doctor and make a movement as to rise from my chair. He gets up, I say good bye, he muffles something and leaves, shaking his head.

This, certainly, is an unusual situation to develop during an office visit, but it may serve its purpose as a rather amusing example of failed communication. However, I am quick and sorry to say 'too bad,' because his rash looked like a kind of poison ivy rash, so a remedy possibly could have been found easily.

And then this case: A woman comes for her first appointment. On entering the consultation room with me, she begins to explain her symptoms even before reaching her chair. I inconspicuously hurry to pick up pen and intake form to take notes of the information bubbling from her active mind. During the next hour and one half I consciously watch the clock, which is placed for me to see without taking attention from the client, and at the end of the consultation I have literally spoken not more than 15 of the 90 minutes.

In the first example the client was very closed right from the start and did not make an effort to establish any communicative contact. Maybe this is simply his character, maybe he suddenly realized he did not really want to deal with natural health and was uncomfortable to say so. Maybe he did not feel comfortable with my person. Maybe all I needed to say was something like: "You had a long day? Seems like you are really concerned about your rash." Maybe at some point during the 'conversation' I could have, kindly or assertively, demanded his cooperation. And maybe I was the one who had a bad day.

In the second example the client was very open right from the start and was eager to portray as much information of her situation and condition as she could. Although, or because, this resulted in a somewhat one-way communication, not only was it sufficient to make a good case, it actually helped find her remedy. Again, maybe this is her general character and she always behaves like this; maybe she immediately felt comfortable with me, my appearance, or the office.

These two cases lead me to another aspect, which I believe is important to consider. Clients and practitioners alike are human beings. The main difference between them is that it is the client who talks about her or his symptoms. It does not mean that homeopaths do not have any symptoms themselves. It is easy, as a homeopath, and after having taken lots of remedies for oneself, or after having been treated constitutionally, to think one were healthy on all levels. But we all have our own issues — physical, mental, emotional.

The practitioner may exhibit symptoms of his own, be they ever so subtle or subconscious, that may interfere with the process of case taking and management. One may become too much emotionally engaged, too sympathetic with the client's suffering, maybe because of one's own similar experiences. Or one may focus too much on the worrisome allopathic diagnosis, maybe because of a forceful presentation by the client, in such a manner as to intimidate the practitioner. The practitioner may have a need to be admired, respected, or liked, or may have insecurities, any of which can lead to a variety of subtle or obvious behavioral and communicational peculiarities. These, in turn, may not necessarily and in every case result in difficult communication. However, if they do, it is likely to be to the detriment of the client-practitioner relationship.

I know of one Chinese Traditional Chinese Medicine (TCM) practitioner, who would walk me out to the parking lot, wait until I was in the car, and wave good-bye until I was out of sight at the end of the street. In the office he would come to the restroom with the client and wait in front of the door until the client came out again. All the while he would be talking and giving further explanations of his treatments. He is an excellent practitioner of his art and does good help for many people. His peculiar behavior, which may or may not be justified by cultural difference, unless further understood, carries the potential of causing discrepancies in the verbal and non-verbal communication between him and some clients.

It is well worth the time to examine our own issues, especially our own emotional issues, to realize how they can become an integral part of how we take and manage a case, how we run our office in general. Whether we are conscious of this interference or not, it is bound to be part of our work, just as it is part of our general life.

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